More women getting Pap tests as recommended

1:47 January 3, 2013

Younger women (30 and younger) are getting screened consistent with newer national recommendations, according to a report released by the Centers for Disease Control and Prevention. In a second study, CDC reported that 60 percent of women continue to get Pap tests even after having a total hysterectomy. The two studies are published in today’s issue of CDC’s Morbidity and Mortality Weekly Report.

In 2012, the U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists and American Cancer Society recommended that women, beginning at age 21, should start Pap test screening every three years, and that women should not be screened annually. The same groups agree that screening is unnecessary for most women who have had a total hysterectomy (removal of the uterus and uterine cervix) for non-cancerous reasons, or for women aged 65 years and older with several years of normal test results.

“As we monitor Pap test use among U.S. women, we can make sure that women are being screened in accordance with guidelines, to best maximize the benefits of screening and minimize the harms,” said Meg Watson, M.P.H., an epidemiologist with CDC’s Division of Cancer Prevention and Control.

The researchers for both studies analyzed Pap test survey data from CDC’s Behavior Risk Factor Surveillance System during 2000 through 2010. They found that screening has become more consistent with current cervical cancer screening recommendations:

The percentage of women aged 18-21 years who reported never being screenedincreased from 23.6 percent in 2000 to 47.5 percent in 2010. Screening is not recommended for women under the age of 21.

In 2010, recent Pap testing (within three years) dropped among women aged 30 years and older without a hysterectomy, primarily due to declines among women aged 65 years and older (from 73.5 percent in 2000 to 64.5 percent).

For women aged 30 years and older who had a hysterectomy, Pap testing declined from 73.3 percent in 2000 to 58.7 percent in 2010.

They also found that contrary to recommendations:

The percentage of women aged 22-30 years who had not been screened increased from 6.5 percent in 2000 to 9.0 percent in 2010.

Women aged 30-64 years who did not have health insurance and had not had a hysterectomy were less likely to have received a Pap test within the previous three years — from 74.4 percent in 2000 to 68.7 percent in 2010.

“The good news is we are focusing our public health efforts on women at highest risk, while decreasing screening for women under age 21, when cervical cancer is rare and screening is not recommended,” said Keisha Houston, Dr.Ph., Epidemic Intelligence Service officer with CDC’s Division of Cancer Prevention Control. “We need to remain vigilant and increase screening among women who would benefit most from this preventive service.”

Because of the Affordable Care Act, many private health plans and Medicare now cover certain preventive services, including cervical cancer screening, with no copays or other out-of-pocket costs.

CDC’s National Breast and Cervical Cancer Early Detection Program provides low-income, uninsured, and underinsured women access to timely cervical and breast cancer screening and diagnostic services in all 50 states, the District of Columbia, five U.S. territories, and 11 American Indian/Alaska Native tribes or tribal organizations.

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